Diagnosis of Frontotemporal Dementia
The diagnosis of frontotemporal dementia can be challenging due to the wide variety of symptoms and the fact that frontotemporal dementia often mimics psychiatric disorders or other forms of dementia. Accurate and early diagnosis is essential to ensure appropriate treatment, planning, and support for the individual and their family.
Clinical Evaluation
The diagnostic process begins with:
A detailed history of symptoms, including changes in behaviour, language, or movement
Information from close family members or caregivers, who may notice changes the individual doesn’t
Neurological and cognitive tests, to assess memory, reasoning, speech, and behaviour patterns
Because early-stage FTD doesn’t usually affect short-term memory, standard dementia screening tools may not always detect it.
Brain Imaging
To confirm the diagnosis and rule out other causes, doctors may order imaging tests such as:
MRI (Magnetic Resonance Imaging) – can reveal shrinkage in the frontal and temporal lobes
CT scan – may show structural changes in the brain
PET or SPECT scans – show how the brain is functioning and highlight areas of reduced activity, even before major shrinkage is visible
These scans help differentiate FTD from other conditions like Alzheimer’s disease or vascular dementia.
Neuropsychological Testing
A neuropsychologist may carry out:
Detailed assessments of speech, language, and executive function
Tests to evaluate the ability to plan, organise, or interpret social cues
Emotional recognition tests, particularly for individuals with behavioural symptoms
These tools help identify specific deficits that align with different subtypes of FTD.
Blood Tests and Genetic Screening
While there is no blood test that confirms FTD, doctors may use blood tests to:
Rule out other medical conditions, such as thyroid problems, infections, or vitamin deficiencies
In inherited cases, genetic testing may be offered to identify mutations in genes like MAPT, GRN, or C9orf72
Genetic counselling is strongly recommended before and after testing.
Differential Diagnosis
FTD is often misdiagnosed as:
Depression or bipolar disorder
Alzheimer’s disease
Autism spectrum disorders, particularly in younger adults
A team approach involving neurologists, psychiatrists, and speech therapists often leads to more accurate results.
Diagnosis of Frontotemporal Dementia
A confirmed diagnosis of frontotemporal dementia allows families to access care resources early, plan for the future, and participate in research or clinical trials if appropriate.
